Think you have ugly toenails? What should you do?
4/28/2025 by Denise Dupras, M.D., Ph.D.
Toenails may have an altered appearance for many reasons — including injury to the nail, underlying illnesses like psoriasis, or, more commonly, a fungal infection called onychomycosis, which can occur in up to 10% of the population. Generally, there are no symptoms.
Nail appearance
- Discolored — usually yellow, white or brown.
- Thickened.
- Brittle.
- Ragged.
- Pulled away from the underlying skin.
Risk factors for onychomycosis
- Fungal infection of the skin of the foot, more commonly known as Athlete's foot.
- Increased age.
- Extended exposure to moisture, sweating of the feet or being barefoot in moist environments such as swimming pools, shower rooms and gyms.
- Underlying illnesses, including psoriasis, diabetes or impaired circulation.
Onychomycosis is contagious, so to prevent the spread, thoroughly clean shared shower stalls or wear shower shoes.
Treatment is not usually required, but it is essential to consult your healthcare clinician if you experience bleeding, pain, infection or spread of color changes at the base of your nail.
Prescription medications can include topical remedies that can be applied to the skin and nails, but those are much less effective than oral medications. Since nails grow slowly, oral medications must be used for 12 weeks, and laboratory tests must be monitored. These medications can also interact with other medicines. Topical medications, in some cases, require use for much longer, up to 48 weeks, but are unlikely to interact with other drugs.
Denise Dupras, M.D., Ph.D., is a physician in Primary Care in Rochester and Kasson's Division of Community Internal Medicine, Geriatrics and Palliative Care. She completed her medical and doctoral degrees at Mayo Clinic Alix School of Medicine and her residency in internal medicine at Mayo Clinic in Rochester. Her interests include medical education and evidence-based medicine.